NPIMap

Organization Active NPI

Summit Smiles PLLC

  • General Practice Dentistry
  • Centennial, CO
National Provider Identifier
1013662774
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SUMMIT SMILES PLLC
Practice address
7300 E Arapahoe Rd Ste 500
Centennial, CO 80112-6147
Phone
(720) 638-6361
Fax
(720) 583-1354
NPI assigned
Feb 21, 2022
Organization subpart
Yes
Parent organization
SUMMIT SMILES PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John Lydiatt, DDS
Title
Owner
Phone
(720) 638-6361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

7300 E Arapahoe Rd Ste 500
Centennial, CO 80112-6147

Mailing address

7300 E Arapahoe Rd Ste 500
Centennial, CO 80112-6147
Phone (720) 638-6361

National Provider Directory

National Provider Directory
Tax ID family
Summit Smiles PLLC5 organizations share this tax ID, including this one
Part of
Summit Smiles PLLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7300 E Arapahoe Rd
Ste 500
Centennial, CO 80112
Phone (720) 243-3593

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1013662774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 E ARAPAHOE RD STE 500",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126147",
            "telephone_number": "720-638-6361",
            "fax_number": "720-583-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 E ARAPAHOE RD STE 500",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126147",
            "telephone_number": "720-638-6361",
            "fax_number": "720-583-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SMILES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT SMILES PLLC",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "LYDIATT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-638-6361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.